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i <br /> ELECTRICAL PERMIT APPLICATI4N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � �/ ��� ? �P/l �ll��'c'_Il ��J � . <br /> PROJECT ADDRESS <br /> ` f ��� l�� ��. ,/j �� �� � �-� �f%� �/ ��G S-� <br /> �/' _ <br /> �Je.�\� �C� �C• 1�1 _ �' ri. !C'iCi �' (i' l Jli <br /> OWI1Cf hiailAddiess Cily StateZip Phone <br /> Tenanl Mail Addmss City State/Zip Phone <br /> - �, - _ , < <p�, �;; - �� , ,, � ��� F� ��� <br /> Electrical Conlraclor Mail Address Cily S�ate2ip Phone <br /> /' /7- � . -� �- �l--- c.- <br /> (' `)�T / �5�f / �� � �- � � U — — <br /> State License Number Contract Price of Work <br /> ��'���rtJ J�E'�.�iifi�.> <br /> Proposed Use of Building Contad Person (Plan Review) <br /> � � ,� /' � /�C��yc i/��� Jiti, ' � <br /> Description af Work to Be Dane: �� ; it r 7 ' c r r� , <br /> —� � , <br /> i t�i� 7� r' it F .i�''C�i�l�U7, �i I�i`Q�E�t� iJiF�+ r / <br /> � <br /> NOTE: W IRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hcreby ccriily that I have read and eaamined fhis applicauon and knoro the same to be true and <br /> ccnecL AU provisions o/laws and ordinances goveming this type al u•odc�vill be cornplefed <br /> whetherspeciGed herein ornoL The grantinc�o(a pennd does not presurne fo give authonty to <br /> violate or cancel fhe provisions o(any other state or locallaw regulating conslruc6on or the <br /> performance o/construction. That 1 arn aufhorized by the owner o/fhis propert}�to pedorm the <br /> work lor which application is made and 1 comply witlt fhe Sfate Confractors La�v 18.27 RCW and r1 <br /> 296.200 WAC. �' q ���J <br /> `L l��l."2 1��:'�C c. � ,..J �`i"�� �.� �� I <br /> Signatwc -' Date <br />